PainRelief.com: What are the main findings?
Response: There were several novel and interesting findings of our study.
We found changes in the shape of the foveal avascular zone as well as reduced foveal perfusion in participants with migraine with aura compared to migraine without aura. We also saw that both migraine groups, those with and without aura had a reduction in blood perfusion in the parafoveal retina during a migraine attack.
Finally, we found that participants with a history of primarily unilateral headaches at baseline had baseline asymmetry between vascular parameters measured in the fovea, with the eye on the side of the headache having increased vascular measures in both migraine with and without aura.
PainRelief.com: What should readers take away from your report?
Response: Using OCTA, we see significant changes in the structure and perfusion of the retina in participants with migraine. This suggests that the use of OCTA in migraine research may be of
benefit for the development of imaging biomarkers.
Interictally, we found changes in the shape of the foveal avascular zone as well as reduced foveal perfusion in participants with migraine with aura compared to migraine without aura, thereby providing a promising biomarker for migraine. We are seeing significant differences in the vascular pattern, specifically in migraine with aura participants and this may allow us to separate subgroups of migraine patients on the basis of their OCTA changes. With further research I do think a pattern of changes seen with OCTA could lead us to a clinically useful biomarker in migraine.
During a migraine attack, we also saw that both migraine groups, those with and without aura had a reduction in blood perfusion in the parafoveal retina during a migraine attack. By using OCTA during an attack, we also show that a non-invasive imaging tool like OCTA has the potential to give us a better understanding of the basic mechanisms of migraine. This may lead to new treatments in migraine over time.
Our results also raise the possibility that reduced retinal perfusion could play a role in visual symptoms that occur during a migraine attack. The long-term effects of these changes require further longitudinal studies however this may allow us to screen for patients that may have a higher risk of vascular complications in the future or monitor treatment efficacy over time. OCTA imaging might help neurologists identify patients most at risk for future vascular events.
PainRelief.com: What recommendations do you have for future research as a result of this study?
Response: The changes we see of reduced parafoveal perfusion during migraine attacks are an interesting finding. It is unclear if this contributes to symptoms during a migraine attack, however it is possible that it may be related to some visual symptoms we see during migraine attacks including blurred vision. This question requires further research. Additionally, any long-term effects of this reduction of blood flow during attacks will need to be evaluated and future longitudinal studies can help us evaluate this.
PainRelief.com: Is there anything else you would like to add?
Response: Imaging the vasculature of the eye using OCTA has shown to be a viable and exciting way to study migraine. This imaging tool may play an important role in developing an imaging biomarker for migraine and also furthering our understanding of basic mechanisms of migraine.
Any disclosures? No.
Citation: Podraza K, Bangera N, Feliz A, Charles A. Reduction in retinal microvascular perfusion during migraine attacks. Headache. 2023; 00: 1-21. doi:10.1111/head.14654
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Last Updated on January 18, 2024 by PainRelief.com